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Alaska rates for HCPCS 15273

Application of skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$871.48 / $7,340.00 / $13,413.92
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$197.85 / $967.82 / $1,470.36
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$346.83 / $515.66 / $995.43
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$967.82 / $1,383.98 / $2,058.50
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$468.23 / $561.87 / $885.00
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$469.60 / $839.55 / $1,309.50
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$967.82 / $1,383.98 / $2,058.50
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$360.84 / $764.40 / $1,399.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$339.34 / $796.34 / $1,201.35